Darshan singh Singh

• PhD
• Senior Lecturer at University of Science Malaysia

Methamphetamine (METH) consumption is associated with aggression. Decoction derived from the kratom (Mitragyna speciosa Korth.) leaf has been used as a METH substitute in Southeast Asia. Given its perceived benefit, we investigated the relationship between kratom use and aggression in a treatment sample of METH users with and without kratom use his...

Kratom/ketum is a psychoactive herbal preparation that has been used for a long time as a remedy and performance-enhancing substance in Southeast Asia. The advancement of globalization is making kratom increasingly more available in the western world, where it is becoming increasingly more used. The current research on kratom and its ingredients is...

Introduction: Kratom (Mitragyna speciosa) is a medicinal tree native to Southeast Asia. The present multilevel meta-analysis describes the association between kratom use and the positive and negative indicators of mental health. Methods: A total of thirty-six articles were included in the meta-analysis to examine the associations, using a random...

Women who use drugs (WWUDs) face elevated risk of intimate partner violence (IPV) and unsafe sexual behaviours. This prevalence study, involving 200 WWUDs in a mandated drug rehabilitation program, examined risky sexual behaviours, family planning knowledge among IPV victims, and barriers to contraceptives or condoms use. The majority were Malays (...

Malaysia has retained the death penalty for violent crimes and some nonviolent drug offenses. Major news dailies, controlled by political parties in the ruling coalition, have helped justify this stance in the past. This situation changed over 22 months when a new coalition, which campaigned on abolishing capital punishment, took office and sparked...

Mitragyna speciosa Korth also known as kratom, is an herbal drug preparation for its therapeutic properties and opioid-replacement therapy. Kratom is consumed in a brewed decoction form in Malaysia and to date, no studies have characterized its chemical and toxicity profile. Thus, this study aims to evaluate kratom decoction's safety and toxicity p...

Background and aims Kratom (Mitragyna speciosa Korth.) is widely use worldwide despite its addictive potential. Although psychostimulant use has been linked to occurrence of endoplasmic reticulum (ER) stress, data is lacking on how regular kratom use affects ER stress. This case-control study first determined differences in ER stress sensor protein...

Background: Mitragyna speciosa or Kratom has been used in Thailand traditionally for its medicinal value. Despite case reports of kratom consumption causing adverse effects, research on its long-term health impact is limited. This study examines the long-term health impact of kratom use among people in Southern Thailand. Methods: Three community...

DID ALCOHOL REDUCE HEROIN USE? A HIGHLIGHTFROM HIV/HCV CO- INFECTED METHADONEMAINTENANCE PATIENTS IN MYANMARS. Tun 1, V. Balasingam 2, D. Singh 21 Myanmar Medical Association, MMA, Yangon,Myanmar2 Universiti Sains Malaysia, Centre for Drug Research,Penang, MalaysiaIntro: The HIV/HCV co-infection prevalence among people whoinject drugs (PWIDs) in My...

Purpose of Review This systematic review examines case reports of kratom physical dependence or addiction, focusing on assessment, diagnosis, and treatment methods and the completeness of the clinical data presented. Recent Findings Most peer-reviewed clinical literature on kratom physical dependence and addiction comes in the form of case reports...

Purpose of review In this systematic review, we examined case reports of patients who use kratom and evaluated their rigor based on reporting of clinically relevant information. Recent findings Millions of people use kratom in the USA each year. Despite its prevalence, there is little peer-reviewed clinical literature available on kratom, and clin...

Many researchers have noted that media coverage of drugs can be sensationalized and/or have questionable accuracy. Additionally, it has been alleged that the media often treats all drugs as harmful and can fail to differentiate between different types of drugs. Within this context, the researchers sought to deconstruct how media coverage was simila...

Kratom (Mitragyna speciosa Korth.) use has increased substantially over the past decade outside of its indigenous regions, especially for the self-treatment of psychiatric conditions. An anonymous, cross-sectional, online survey was completed by 4,945 people who use kratom (PWUK) between July 2019 and July 2020. A total of 2,296 respondents complet...

This Letter to the Editor is a response to Broyan and colleagues who recently published a Case Report presenting data on 28 patients in the United States who identified kratom as their primary substance of use and who were subsequently induced on buprenorphine/naloxone for a reported diagnosis of kratom use disorder. We applaud the authors for help...

Women with substance use disorders (SUDs) have been widely reported to face barriers in seeking treatment. We sought to identify barriers that prevented women who use methamphetamine (WWUM) from accessing the decade-old Voluntary Treatment Centers (VTCs) in Malaysia. A total of 153 WWUM who were undergoing rehabilitation for methamphetamine use at...

Abstract Title: DID ALCOHOL REDUCE HEROIN USE? A HIGHLIGHT FROM HIV/HCV CO-INFECTED METHADONE MAINTENANCE PATIENTS IN MYANMAR Presenting Author: Sun Tun #ISIDCongress2022

The Drug Dependency Treatment and Research Unit (DDTRU) in Myanmar established opioid substitution with methadone in 2006. Reducing HIV transmission could be affected by eliminating the unsafe needle sharing among injecting drug uses and treatment with opioid substitution. The quality of life (QOL) among the clients retained in the methadone progra...

Kratom (Mitragyna speciosa Korth.) use has increased substantially over the past decade outside of its indigenous regions, especially for the self-treatment of psychiatric conditions. An anonymous, cross-sectional, online survey was completed by 4,945 people who use kratom (PWUK) between July 2019 and July 2020. A total of 2,296 respondents complet...

Background Kratom (Mitragyna speciosa korth), has been used traditionally in Southeast Asia for its therapeutic properties. The major alkaloid of kratom, mitragynine binds to opioid receptors to give opioid‐like effects that causes addiction. In our previous study, we have identified AZ122 as a unique biomarker in habitual or regular kratom users t...

Background: Kratom (Mitragyna speciosa Korth.) use outside of Southeast Asia has increased over the past decade. Objectives: This investigation clarifies kratom's role in perceived well-being, overall health, and temporal correlation with drug use to understand kratom's role in the self-treatment of substance use disorders (SUDs). Methods: Bet...

Objectives: This study determined the association between expression of the endoplasmic reticulum (ER) stress sensor mRNA in the peripheral leukocytes and the patterns of kratom use and evaluated the correlations between the levels of the ER stress sensor mRNA and the severity of kratom dependence and kratom induced depressive symptoms among peopl...

Background To tackle the long-standing opioid misuse problem, Myanmar introduced the methadone maintenance treatment (MMT) program in 2006, starting with 260 clients. Since then, the program has been expanded across different geographical sites in the country. This study was done in 2017 to explore the treatment satisfaction of the clients towards...

Females who use drugs (FWUDs) are at risk of continuing illicit substance use during pregnancy and breastfeeding. We investigated the prevalence rates and factors associated with these practices in a sample of 200 FWUDs recruited from a publicly-run drug rehabilitation center. A semi-structured questionnaire was used to collect the data. The majori...

Objective The spheroid model provides a physiological platform to study cancer cell biology and drug sensitivity. Usage of bovine collagen I for spheroid assays is costly especially when experiments are conducted in 24-well plates, as high volume of bovine collagen I is needed. The aim of the study was to downsize spheroid assays to a microfluidic...

Mitragyna speciosa (Korth.) also known as kratom or ketum has been traditionally used for its diverse medicinal value in Southeast Asia. Despite of its therapeutic value, kratom’s safety profile remains deficiently elucidated. Our study aims to characterize the urinary protein profile of regular kratom users to determine its toxic effects on renal...

Penggunaan media sosial dalam kempen kesihatan di Malaysia kebelakangan ini dilihat kian dipentingkan. Senario positif ini memberikan gambaran bahawa pelbagai pihak mulai melihat kelebihan yang dimiliki oleh medium ini dalam membantu menangani isu-isu yang menjadi risiko dan ancaman kepada kesihatan awam. Walau bagaimanapun, kajian-kajian yang dija...

Background: Kratom or Mitragyna speciosa (Korth.) has received overwhelming attention recently due to its alleged pain-relieving effects. Despite its potential therapeutic value, kratom use has been linked to many occurrences of multiorgan toxicity and cardiotoxicity. Accordingly, the current narrative review aimed to provide a detailed account of...

Background HIV prevalence among people who inject drugs (PWIDs) in Myanmar was 34.9%. This analysis identifies how methadone dose affects treatment satisfaction of HIV patients. Method A total of 210 patients on methadone at least 6 months were recruited from five cities using stratified random sampling in Myanmar. Verona Service Satisfaction Scal...

Background HIV can be transmitted through the sexual route. This study explores the association of sexually transmitted infections (STI) with other infections, risky and illicit drug-use behaviour among people who inject drugs (PWIDs) treated on methadone. Method A total of 210 respondents from five cities across Myanmar were recruited through str...

Background HIV prevalence rate among people who inject drugs (PWIDs) in Myanmar is marginally high (34.9%). HIV transmission can be reduced and prevented through harm-reduction programs such as methadone maintenance treatment (MMT) and needle syringe exchange program (NSEP). We sought to determine the relationship between methadone dose and injecti...

Multiorgan toxicities have been extensively reported in kratom (Mitragyna speciosa Korth) users in Western countries but not in Southeast Asia. Existing literature argued that this discrepancy may be due to underreporting of kratom-related toxicity cases in Southeast Asia. Hence, this case series filled the research gap by clinically assessing the...

Abstract Background Opioid substitution with methadone maintenance treatment (MMT) is shown to reduce illicit opioid use and renew social functioning. Understanding factors that undermine clients’ social functioning during MMT treatment is vital for improving treatment compliance and quality of life. Method A total of 210 respondents who were alrea...

Background To address the long-standing opioid abuse problem, Myanmar has established the methadone maintenance treatment (MMT) program in 2006. This study aims to determine client’s treatment satisfaction towards MMT program in Myanmar. Method A total of 210 clients who have registered in MMT program with a minimum of six-month treatment history w...

Ethnopharmacological relevance: Mitragyna speciosa (Korth.) or kratom is a medicinal plant indigenous to Southeast Asia. The leaf of M. speciosa is used as a remedy in pain management including cancer related pain, in a similar way as opioids and cannabis. Despite its well-known analgesic effect, there is a scarce of information on the cancer-supp...

Females who use drugs (FWUDs) are vulnerable to intimate partner violence (IPV). This study was initiated to identify factors that evoke IPV, and identify barriers that preclude FWUDs from seeking help. Two-hundred FWUDs were recruited from a mandatory drug rehabilitation centre (CCRC) for this cross-sectional study. The data were collected through...

Objective : Cannabis use is criminalized in Malaysia under existing drug laws, despite the prevailing contrasting views towards cannabis regulation. We sought to determine the motives for using cannabis, perceptions regarding the risks of using it, and the legal ramifications related to its use among employed graduates in Malaysia. Design : Twenty...

Objectives: Kratom (Mitragyna speciosa Korth.), an indigenous medicinal plant, has been widely used as a traditional remedy in Southeast Asia. However, its combined consumption with other substances has received scarce attention. This study investigates the use of kratom among adults with a history of using heroin and methamphetamine in Malaysia....

Background: Restrictive orders and temporary programmatic or ad hoc changes within healthcare and other supportive systems that were implemented in response to the COVID-19 epidemic in Malaysia may have created hindrances to accessing healthcare and/or receiving other supportive services for people who use drugs (PWUDs). Design: A primarily qualita...

People who use amphetamine-type stimulant (ATS) are known to face barriers in seeking treatment. We sought to identify these barriers and gender differences in barriers (if any) faced by them. A convenience sample of 386 respondents who use ATS was recruited from five formal drug rehabilitation centers for this cross-sectional study. The majority w...

It has been well-established that, in the USA, the news media contributes to the construction of moral panics regarding the use and users of various types of drugs. In this study, we utilize the moral-panic framework to understand how the media depicts drug use in Malaysia. We used content analysis of two widely read English-language Malaysian news...

Kratom (Mitragyna speciosa) is a tree native to Southeast Asia with long history of traditional medicinal use. The aim of this study was to investigate the nature of self-reported exported experiences as shared on YouTube™ videos. A total of 500 videos with 19,478,180 views and 134, 863 comments emerged from the data scrape extracted via the YouTub...

Ten indole and oxindole alkaloids (1-10) were isolated from the freshly collected leaves of Malaysian Mitragyna speciosa (Kratom). The chemical structures of these compounds were established on the basis of extensive 1D and 2D NMR and HRMS data analysis. The spectroscopic data of mitragynine oxindole B (4) are reported herein for the first time. Th...

Background Kratom ( Mitragyna speciosa Korth.) is a traditional folk remedy used in Southeast Asia and is known to have a significant opioid-like effect. However, it is unknown whether kratom consumption can impair quality of life (QoL). This study aimed to examine the QoL of people who use kratom by comparing it with that of healthy non-kratom usi...

Background Kratom (Mitragyna speciosa Korth.) is a medicinal plant, widely used in Southeast Asia chiefly for its unique medicinal properties in treating chronic pain, opioid dependence and withdrawal, and as a mood enhancer. Method Relevant articles describing kratom's medicinal utility was identified and reviewed. Results In traditional setting...

Background: Opioid substitution with methadone maintenance treatment (MMT) is shown to reduce illicit opioid use and renew social-functioning. Understanding factors that undermine clients’ social-functioning during MMT treatment is vital for improving treatment compliance and quality of life. Method: A total of 210 respondents who were presently en...

Objective: The spheroid model provides a physiological platform to study cancer cell biology and drug sensitivity. Usage of bovine collagen I for spheroid assays is costly especially when experiments are conducted in 24-well plates, as high volume of bovine collagen I is needed. The aim of the study was to downsize spheroid assays to a microfluidic...

Ethnopharmacological relevance Cisplatin is the standard of care treatment for patients diagnosed with nasopharyngeal carcinoma, where it is administered concurrently with radiotherapy in patients diagnosed with primary NPC or locoregionally advanced NPC. Patients respond to cisplatin well but eventually develop resistance to the drug making subseq...

Introduction: Kratom or (Mitragyna speciosa) leaves are consumed as a folk remedy and opioid substitute in the Southeast Asian region. There is still a lack of information about the long-term or toxic-causing effects of kratom use. Methods: A total of thirteen regular kratom users, with long-term (>20 twenty years) kratom use history were recruited...

Background: Tuberculosis (TB) is one of the global burdens of diseases and one-third of the global population is infected. In Myanmar, there were an estimated 93,000 people who inject drugs according to 2017 IBBS survey and the HIV prevalence rate was 34.9%. WHO highlights that people with HIV had 16–27 times more likely to develop TB and this stud...

Kratom (Mitragyna speciosa Korth., Rubiaceae) is native to and has traditional use in Southeast Asia. The number of kratom users outside of Southeast Asia has increased significantly in recent decades with use spreading to the Unites States (US) and Europe. Because of its reputed opioid-like psychoactive effects at higher doses, kratom has been reg...

Among the symptoms of COVID-19 fever, general malaise, pain and aches, myalgia, fatigue, and headache can affect the quality of life of patients, even after the end of the acute phase of the infection and can be long lasting. The current treatment of these symptoms, also because COVID-19 patients have been asked not to use non-steroidal anti-inflam...

Out-of-treatment HIV positive opiate users often engage in risky injecting and sexual behaviors. We sought the self-reported experiences on whether or not kratom (Mitragyna speciosa Korth.) use was associated with a reduction in HIV risk behaviors among them. A convenience sample consisting of thirty-two HIV positive opiate users participated in th...

Research selected for presentation at the 19th International Congress on Infectious Diseases (ICID)

Amphetamine-type-stimulant (ATS) use in Malaysia has surged but the relationship between ATS use and crime remains poorly investigated. Our study sample consisted of 149 self-reported people who use ATS detained for armed, unarmed, and narcotic offences in a centre in Penang, Malaysia. All information was elicited through personal interviews using...

Objectives: Little is known about the cardiotoxic effects of kratom (Mitragyna speciosa Korth.), a medicinal plant. This analytical cross-sectional study investigated the prevalence of electrocardiogram (ECG) abnormalities and QTc intervals in regular kratom users compared with non-kratom-using control subjects. Methods: We enrolled regular krat...

Background People caught using amphetamine-type-stimulants (ATS) in Malaysia can either be incarcerated and subsequently be placed in a community supervision programme or if they can afford the fine, be directly sent for community supervision. We sought to determine if treatment compliance in the community supervision varied between the two groups....

Background: Kratom has a long history of traditional medicine use in Southeast Asia. Consumption of kratom products has also been reported in the US and other regions of the world. Pain relief is among many self-reported kratom effects but have not been evaluated in controlled human subject research. Methods: Kratom effects on pain tolerance were a...

Background and aim Kratom, or Mitragyna speciosa Korth., is a tropical plant that has been reported to exhibit opioid-like effects. Although opioids have been demonstrated to alter the lipid profile of regular users, data on the lipid-altering effects of kratom are scarce. This study aimed to compare the fasting lipid profile of regular kratom user...

Purpose of review: The aim of this review is to provide an update on recent trends of new psychoactive substances (NPS) and strategies to manage them. Recent findings: The number of NPS has increased from 166 in 2009 to 892 in 2018, with about 36% having stimulant effects. However, the detection of new stimulant NPS has stabilized since 2015. De...

The protocol describe the steps involved in conducting fasting lipid profile and liver function test from the blood samples of regular kratom users and healthy non-kratom using subjects in this study. This tests were conducted in an ISO 15189-certified laboratory at Advanced Medical and Dental Institute, Universiti Sains Malaysia. The blood paramet...

Background: Treatment-seeking opiate dependents in Methadone Maintenance Treatment (MMT) programs are predisposed to methamphetamine use. This study sought to determine the prevalence, reasons, and perceptions toward methamphetamine use among clients in primary and private MMT programs in Klang Valley (Malaysia). Method: 231 methadone users (n = 15...

Kratom (Mitragyna speciosa), an indigenous medicinal plant of Southeast Asia, is believed to be harmful. We compared the perceptions toward kratom use among kratom users and non-users in Malaysia. 356 respondents (137 kratom users and 219 non-users) were recruited for this cross-sectional study. The majority of respondents were male (60%, n = 212/3...

Ethnopharmacological relevance: Kratom (Mitragyna speciosa) is a native medicinal plant of Southeast Asia widely reported to be used to reduce opioid dependence and mitigate withdrawal symptoms. There is also evidence to suggest that opioid poly-drug users were using kratom to abstain from opioids. Aim of the study: To determine the patterns and...

This study sought to determine the relationship between kratom (Mitragyna speciosa) initiation and regular consumption of illicit drugs and HIV risk behaviors in a cohort of illicit drug users in Malaysia. 260 illicit drug users with current kratom use were recruited through convenience sampling for this cross-sectional study. All were male, with t...

Factors associated with poly-drug use among people who inject drugs treated on methadone

Introduction: Kratom which is a tropical plant use as traditional remedy in rural areas of Malaysia and Thailand has recently been a research focus worldwide due to its potential as substitution therapy for opioid addiction. However, data on its effect on the quality of life of kratom users is scarce. This study aimed to describe the socio-demograp...

Objectives: To determine whether diagnosed pre-existing health conditions correlate with Kratom demographics and use patterns. Methods: A cross-sectional, anonymous US national online survey was conducted among 8049 Kratom users in October, 2016 to obtain demographic, health, and Kratom use pattern information. Results: People who use Kratom t...

Kratom (Mitragyna speciosa) is a tree-like plant indigenous to Southeast Asia. Its leaves, and the teas brewed from them have long been used by people in that region to stave off fatigue and to manage pain and opioid withdrawal. Evidence suggests kratom is being increasingly used by people in the United States and Europe for the self-management of...

Background: Mitragyna speciosa (Korth.) or kratom is an indigenous medicinal plant of Southeast Asia. Kratom is widely reported to have dose-dependent effects based on available literature, but to our knowledge, this has not been established conclusively. Objective: This study sought to evaluate if kratom use produces dose-dependent effects, with a...

Poster presented in 5th International HIV/Viral Hepatitis Co-Infection Meeting, 20-21 July 2019, Abstract ID: 1615 10th IAS Conference on HIV Science (IAS 2019), Mexico City, Mexico, 21 to 24 July 2019, Abstract ID: WEPEC509 Title: “Heroin Use and Sexual Risk Behaviours among HIV/HCV co-infected Methadone Patients in Myanmar” Awarded "2019 IAS Inje...

A R T I C L E I N F O Keywords: Kratom use Psychosis Psychotic symptoms severity Malaysian kratom users A B S T R A C T Background: Kratom is a traditional medicinal herb widely used in Malaysia and Thailand. Despite its widespread use and statements by regulatory agencies on the potential for kratom-associated psychosis, there is little data regar...

Introduction: The use of amphetamine-type stimulants (ATS) is becoming prevalent among clients in Methadone Maintenance Treatment (MMT) program. This study aims to determine the prevalence of, and reasons for, ATS use among clients enrolled in MMT programs in Kuantan, Malaysia. Method: A total of 237 regular methadone users with current ATS use his...

Kratom leaves from Mitragyna speciosa (Korth.) trees are believed to have medicinal value, and have a long-history of folk medicine use for self-treatment of a broad range of indications. In Southeast Asia, traditional uses of kratom include as an aphrodisiac and a sexual performance enhancer. The study evaluated sexual functioning in a cohort of l...

The leaves from Mitragyna speciosa (Korth.) trees, also known as kratom, are traditionally used in Southeast Asia as a mild psychotropic agent. We investigated the demographic characteristics of persons who used both kratom cocktail and benzodiazepines (BZO) in a sample drawn from a rural area in Penang, Malaysia, and the reasons for BZO use. Seven...

Opiate Crisis among People who inject drugs treated with methadone in Myanmar

The usage of media and communication in public health awareness campaign in this country is growing. The usage of media and communication clearly indicates its importance as an effective medium of information delivery. However, studies on the effectiveness of media and communication in public health awareness campaigns are still limited, especially...

Abstract Ethnopharmacological relevance Mitragyna speciosa (Korth.) is a traditional medicinal plant widely used in Southeast Asia for its opioid-like effects. Although kratom produces analgesia through binding of mitragynine and other alkaloids at the mu-opioid receptor (MOR), the association of long-term kratom use with adverse opioid-like effect...

Aim of the study: This present study sought to investigate kratom use motives among regular kratom users in Malaysia. Materials and methods: A total of 116 regular kratom users were recruited for this cross-sectional survey. The Drinking Motives Questionnaire (DMQ) was administered to measure kratom use motives. Results: Our results indicate that h...

Kratom or Mitragyna speciosa (Korth.) is a medicinal plant of Southeast Asia. As a result of its opioid-like effects, it remains unknown whether consumption of kratom tea is associated with impaired cognitive function. We assessed the cognitive function of 70 regular kratom users and 25 control participants using the Cambridge Neuropsychological Te...

Background: User reports suggest that long-term kratom (Mitragyna speciosa Korth., Rubiaceae) consumption can be associated with negative effects like constipation and withdrawal symptoms such as fatigue. We aim to investigate constipation prevalence from kratom use and fatigue severity during kratom cessation in individuals who reported regular in...

Ethnopharmacological relevance: The leaves of Mitragyna speciosa (Korth.) or kratom have been traditionally used in Malaysia and Thailand mainly to enhance work productivity, as a folk remedy for treating common ailments, and as a mood enhancer. Aim of the study: This present study sought to investigate kratom use motives among regular kratom users...

Kratom leaves (Mitragyna speciosa Korth.) are traditionally used in Southeast Asia for their medicinal value. Self-report studies suggest that cessation from chronic kratom tea consumption (freshly brewed kratom tea) was associated with unpleasant psychological symptoms. This study sought to assess the severity of anxiety and depression during krat...

Background: HIV prevalence rate among People who inject drugs (PWID) in Myanmar is high at 28.5%. The transmission of HIV can be reduced by reducing unsafe needle sharing among injecting drug uses and Opioid substitution. National Drug Abuse Prevention and Control Programme in Myanmar has increased financial and programmatic support for Methadone M...